Provider Demographics
NPI:1215454640
Name:ROTHENBERGER, PEGGY (M S, CF-SLP)
Entity type:Individual
Prefix:MRS
First Name:PEGGY
Middle Name:
Last Name:ROTHENBERGER
Suffix:
Gender:F
Credentials:M S, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 E KENWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85201-1602
Mailing Address - Country:US
Mailing Address - Phone:480-834-5112
Mailing Address - Fax:
Practice Address - Street 1:2433 E ADOBE ST
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85213-6803
Practice Address - Country:US
Practice Address - Phone:480-472-2170
Practice Address - Fax:480-472-2105
Is Sole Proprietor?:No
Enumeration Date:2017-08-25
Last Update Date:2017-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist